Transcatheter Aortic Valve Implantation/Replacement (TAVI/TAVR): How It Started, How It's Going, and Where It's Going

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Biomedical Engineering

Background:

• Transcatheter Aortic Valve Implantation/Replacement (TAVI/TAVR) has advanced since its inception in 2002.
• Initially for high-risk patients, TAVI is now approved for individuals aged 70+ with severe tricuspid aortic stenosis and suitable anatomy.

Purpose of the Study:

• To review advancements in TAVI/TAVR procedures and transcatheter heart valve (THV) technology.
• To highlight the importance of preprocedural planning, current guidelines, and individualized device selection.
• To introduce polymeric heart valves as a potential solution for bioprosthetic dysfunction.

Main Methods:

• Review of TAVI/TAVR advancements, including preprocedural planning, THV system evolution, and operator experience.
• Analysis of current guidelines and device selection criteria.
• Brief discussion of emerging polymeric heart valve technology.

Main Results:

• TAVI/TAVR indications have expanded to include a broader patient population.
• Improvements in technology and planning have enhanced procedural success and safety.
• Next frontiers include TAVI in younger patients, redo TAVI, and THV durability.

Conclusions:

• TAVI/TAVR has become a mainstream treatment for severe aortic stenosis.
• Continued innovation in THV technology and procedural techniques is crucial.
• Polymeric heart valves show promise in addressing long-term valve durability issues.